Race and Family History Influence Risk of Polycystic Ovary Syndrome

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Ehrmann DA, Kasza K, Azziz R, et al., for the PCOS/Troglitazone Study Group: Effects of race and family history of type 2 diabetes on metabolic status of women with polycystic ovary syndrome. J Clin Endocrinol Metab 90:66-71, 2005.

What is the problem and what is known about it so far?

A woman's race and whether a family member has type 2 diabetes makes her more likely to have impaired glucose tolerance and get type 2 diabetes herself. People with impaired glucose tolerance have blood glucose levels that are higher than normal but not high enough to be diagnosed with diabetes.

Many women with polycystic ovary syndrome also have impaired glucose tolerance and diabetes. Polycystic ovary syndrome is a group of signs and symptoms that includes ovarian cysts, obesity, infertility, excess body and facial hair, and high insulin levels, among other signs. About 5% to 8% of all women have polycystic ovary syndrome.

The researchers hoped to find a link between race or family medical history and impaired glucose tolerance, type 2 diabetes, and other things that increase the chances of women with polycystic ovary syndrome getting diabetes.

Who was studied?

The study involved 408 women with polycystic ovary syndrome who had not been through menopause. It did not include women who had a hysterectomy (the surgical removal of a woman’s uterus), were diagnosed with diabetes, heart and blood vessel disease, or who had cancer within the past 5 years.

How was the study done?

Researchers collected information each participant, including age, body mass index (a measure of weight in relation to height), waist size, blood glucose and insulin measures, and levels of several different hormones.

The researchers looked for any links between these measures and the womens' race and family history of type 2 diabetes.

What did the researchers find?

The results support the findings of other studies showing that many women with polycystic ovary syndrome often had family members who had type 2 diabetes.

Women with polycystic ovary syndrome and impaired glucose tolerance or type 2 diabetes had even more family members with a history of type 2 diabetes.

Seven of the 16 women (44%) who had polycystic ovary syndrome and type 2 diabetes had a mother or father with type 2 diabetes.

Thirty-seven of the 94 women (39%) who had polycystic ovary syndrome and impaired glucose tolerance also had a mother or father with type 2 diabetes.

Only 21% (62 of 298 women) with polycystic ovary syndrome and normal glucose tolerance had a parent with type 2 diabetes.

Black women with polycystic ovary syndrome had higher levels of insulin and were more insulin resistant than white women with polycystic ovary syndrome. (Insulin resistance is when the normal amount of insulin released by the pancreas cannot do its job of letting glucose enter the body's cells. Even if the pancreas releases extra insulin, glucose can build up in the blood, causing high blood glucose or type 2 diabetes.)

What were the limitations of the study?

Information about whether a patient's family members had type 2 diabetes was based on patients' reports and not on direct medical tests of the family members.

What are the implications of the study?

Both race and family history of type 2 diabetes can have a strong impact on whether a woman with polycystic ovary syndrome might develop high blood glucose and insulin resistance, which could lead to diabetes.

If you have polycystic ovary syndrome, understanding your racial background and family medical history could help your doctors avoid some of these problems, such as impaired glucose tolerance and type 2 diabetes.